与非手术治疗后阑尾炎复发相关的因素。
Factors associated with recurrent appendicitis after nonoperative management.
机构信息
Division of General Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Division of General Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
出版信息
Am J Surg. 2023 May;225(5):915-920. doi: 10.1016/j.amjsurg.2023.03.005. Epub 2023 Mar 11.
BACKGROUND
The objective of this study is to identify predictors for recurrent appendicitis in patients with appendicitis previously treated nonoperatively.
METHODS
This is a prospective cohort study of all adult patients with appendicitis treated at a tertiary care hospital. Patient demographics, radiographic information, management, and clinical outcomes were recorded. The primary outcome was recurrent appendicitis within 6 months after discharge from the index admission. Given the competing risk of interval appendectomy, a time-to-event competing-risk analysis was performed.
RESULTS
Of the 699 patients presenting with appendicitis, 74 were treated nonoperatively (35 [47%] were women; median [IQR] age, 48 [33,64] years), and 21 patients (29%) had recurrent appendicitis. On univariate and multivariate analysis, presence of an appendicolith on imaging was the only factor associated with a higher risk of recurrent appendicitis (p = 0.02).
CONCLUSIONS
The presence of appendicolith was associated with an increased risk of developing recurrent appendicitis within 6 months.
背景
本研究旨在确定先前接受非手术治疗的阑尾炎患者中阑尾炎复发的预测因素。
方法
这是一项对在三级保健医院接受治疗的所有成年阑尾炎患者进行的前瞻性队列研究。记录患者的人口统计学、影像学信息、治疗方法和临床结局。主要结局是在指数入院出院后 6 个月内发生阑尾炎复发。考虑到间隔期阑尾切除术的竞争风险，进行了时间到事件竞争风险分析。
结果
在 699 例患有阑尾炎的患者中，74 例接受了非手术治疗（35 [47%] 为女性；中位 [IQR] 年龄，48 [33,64] 岁），21 例（29%）发生了阑尾炎复发。在单因素和多因素分析中，影像学上存在阑尾结石是与阑尾炎复发风险增加相关的唯一因素（p = 0.02）。
结论
阑尾结石的存在与 6 个月内发生阑尾炎复发的风险增加相关。
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